Provider Demographics
NPI:1295459758
Name:HEWITT, ARIC MICHAEL (FNP)
Entity type:Individual
Prefix:
First Name:ARIC
Middle Name:MICHAEL
Last Name:HEWITT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 MONCLOVA RD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1841
Mailing Address - Country:US
Mailing Address - Phone:269-352-0559
Mailing Address - Fax:
Practice Address - Street 1:26616 MINGO DR
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5435
Practice Address - Country:US
Practice Address - Phone:269-352-0559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPRN.CNP.0032405OtherADVANCED PRACTICE REGISTERED NURSE